手术与经皮消融治疗复发性肝母细胞瘤的疗效比较

目的比较手术与经皮消融在复发性肝母细胞瘤（HB）患儿中的疗效。 方法回顾性分析于2013年1月至2019年3月在中山大学附属第一医院接受手术（14例）或经皮消融（8例）治疗的22例复发性HB患儿。利用t检验、Wilcox秩和检验、χ²检验等方法比较2组患儿的基线指标或并发症发生率的差异，绘制首次复发治疗后患儿的生存曲线，并利用Log-rank检验比较2组患儿的3年总体生存率及无事件生存率的差异。 结果2组患儿的基线指标比较差异均无统计学意义（P均＞0.05）。消融组和手术组患儿的3年总体生存率分别为75.0%和78.6%（P=0.814），3年无事件生存率分别为50.0%和40.0%（P=0.880）。并发症发生率手术组较消融组更高（78.6% vs 25.0%），差异具有统计学意义（χ²=6.044，P=0.026）。2组患儿均无严重并发症发生。 结论经皮消融治疗复发性HB安全有效，与二次手术相比预后无明显差异。

Efficacy of re-hepatectomy versus percutaneous ablation in treatment of recurrent hepatoblastoma

ObjectiveTo compare the efficacy of re-hepatectomy and percutaneous ablation in the treatment of recurrent hepatoblastoma (HB). MethodsWe retrospectively analyzed 22 recurrent HB patients who received re-hepatectomy (n=14) or percutaneous ablation (n=8) at the First Affiliated Hospital of Sun Yat-sen University from January 2013 to March 2019. The baseline characteristics and rate of complications were compared by the t-test, Wilcoxon test, or χ²-test according to the data type. Survival curves of children after first relapse treatment were drawn, and 3-year overall survival and event-free survival in the two groups were compared using the log-rank test. ResultsThere were no significant differences in baseline characteristics between the two groups. The 3-year overall survival rate in the ablation group and re-hepatectomy group was 75.0% and 78.6% (P=0.814), and the 3-year event-free survival rate was 50.0% and 40.0%, respectively (P=0.880). No severe complications occurred in either group. The rate of complications was significantly higher in the surgery group than in the ablation group (78.6% vs 25.0%, χ²=6.044, P=0.026). ConclusionPercutaneous ablation for recurrent HB is safe and effective, with no significant difference in prognosis compared with secondary surgery.